Isavuconazonium sulfate
[CAS# 946075-13-4]

Identification

• Classification: API >> Synthetic anti-infective drugs
• Name: Isavuconazonium sulfate
• Synonyms: N-Methylglycine [2-[[[1-[1-[(2R,3R)-3-[4-(4-cyanophenyl)-2-thiazolyl]-2-(2,5-difluorophenyl)-2-hydroxybutyl]-4H-1,2,4-triazolium-4-yl]ethoxy]carbonyl]methylamino]-3-pyridinyl]methyl ester sulfate (1:1); BAL 8557-002
• Molecular Formula: C₃₅H₃₅F₂N₈O₅S.HSO₄
• Molecular Weight: 814.84
• CAS Registry Number: 946075-13-4
• EC Number: 619-052-6
• SMILES: C[C@@H](C1=NC(=CS1)C2=CC=C(C=C2)C#N)[C@](CN3C=[N+](C=N3)C(C)OC(=O)N(C)C4=C(C=CC=N4)COC(=O)CNC)(C5=C(C=CC(=C5)F)F)O.OS(=O)(=O)[O-]

Safety Data

• Hazard Symbols: GHS07;GHS08;GHS09 Danger
• Risk Statements: H302-H315-H319-H335-H361d-H372
• Safety Statements: P203-P260-P261-P264-P264+P265-P270-P271-P273-P280-P301+P317-P302+P352-P304+P340-P305+P351+P338-P318-P319-P321-P330-P332+P317-P337+P317-P362+P364-P391-P403+P233-P405-P501

Hazard Classification

Hazard	Class	Category Code	Hazard Statement
Skin irritation	Skin Irrit.	2	H315
Eye irritation	Eye Irrit.	2	H319
Specific target organ toxicity - repeated exposure	STOT RE	1	H372
Chronic hazardous to the aquatic environment	Aquatic Chronic	1	H410
Reproductive toxicity	Repr.	2	H361d
Acute toxicity	Acute Tox.	4	H302
Specific target organ toxicity - single exposure	STOT SE	3	H335

Discovery and Applications

Isavuconazonium sulfate, a prodrug of isavuconazole, was developed by Astellas Pharma and Basilea Pharmaceutica. It was discovered as part of a program to find novel antifungal agents. The compound exhibited potent activity against a broad spectrum of fungi, including Aspergillus and Candida species, which are known to cause serious infections in humans. Isavuconazonium sulfate was designed to improve the pharmacokinetic properties of isavuconazole, enhancing its bioavailability and allowing for intravenous administration.

Isavuconazonium sulfate is primarily used for the treatment of invasive aspergillosis and invasive mucormycosis, which are life-threatening fungal infections commonly found in immunocompromised patients. Its broad-spectrum activity makes it a valuable option for combating fungal resistance and for patients who cannot tolerate other antifungal medications. Additionally, its availability in both oral and intravenous formulations provides flexibility in treatment regimens. Isavuconazonium sulfate has demonstrated efficacy in clinical trials and has been approved by regulatory agencies for use in various countries, offering a promising option for managing serious fungal infections.

References

2024. Successful Isavuconazole Treatment for Pulmonary Mucormycosis in a Patient Intolerant to Liposomal Amphotericin B with Pharmacokinetic Insights: A Case Report. Chemotherapy, 70(4).
DOI: 10.1159/000539652

2024. Safety and effectiveness of isavuconazole in real-life non-neutropenic patients. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 146.
DOI: 10.1016/j.ijid.2024.107070

2024. A global perspective of the changing epidemiology of invasive fungal disease and real-world experience with the use of isavuconazole. Medical Mycology, 62(8).
DOI: 10.1093/mmy/myae083